Chronic obstructive pulmonary disease (COPD) refers to a group of disorders that damage the lungs. These disorders make breathing increasingly difficult over time.
The most common forms of COPD are chronic bronchitis and emphysema. Both are chronic illnesses that impair airflow in the lungs. Most cases of COPD are related to cigarette smoking.
In this disorder, the air passages in the lungs are inflamed. And the mucus-producing glands in the lung's larger air passages (bronchi) are enlarged. These enlarged glands produce too much mucus. This triggers a cough. In chronic bronchitis, this cough is present for at least three months of the year for two or more consecutive years.
You are more likely to develop chronic bronchitis if you:
In this disorder, the tiny air sacs in the lungs (alveoli) are destroyed. The lungs are unable to contract fully. They gradually lose elasticity. Holes develop in the lung tissue. This reduces the lungs' ability to exchange oxygen for carbon dioxide.
Your breathing may become labored and inefficient. You may feel breathless most of the time.
You are more likely to develop emphysema if you:
Some people have an inherited form of emphysema. The lungs lack a protective protein called alpha-1-antitrypsin. In people with alpha-1 antitrypsin deficiency, lung damage can appear as early as age 30.
People with COPD commonly have symptoms of both chronic bronchitis and emphysema.
Chronic bronchitis may have different symptoms in different people.
Your first symptom may be a morning cough that brings up mucus. At first it may only occur during the winter months. In milder cases, a cough produces only a small amount of thin, clear mucus. In other people, the mucus is thick and discolored.
As the illness progresses, the cough begins to last throughout the day and year. It produces more mucus. Symptoms similar to asthma may develop. These include wheezing and shortness of breath.
Eventually, you may develop:
Over time, the airways narrow. Blood pressure increases in the arteries that feed the lungs. This strains the right side of the heart. Eventually, heart failure may develop. Blood backs up in the liver, abdomen and legs.
Chronic bronchitis also makes you prone to frequent respiratory infections. It increases the risk of potentially life-threatening breathing difficulties. These often require hospitalization.
If you have emphysema, you may first feel short of breath during activities such as walking or vacuuming. Lung function decreases slowly in emphysema. You may hardly notice the change as breathing becomes more and more difficult.
With time, you may develop:
The evaluation of COPD often includes some of the following tests:
If your doctor suspects inherited emphysema, blood tests can check for low alpha-1-antitrypsin levels.
If you are diagnosed with inherited emphysema, family members should be tested for alpha-1-antitrypsin deficiency.
Symptoms of chronic bronchitis tend to begin in smokers after age 50. These symptoms gradually worsen for the rest of the smoker's life unless he or she quits smoking.
Most cases of emphysema are diagnosed in smokers in their 50s or 60s. People with the inherited form can show symptoms as early as age 30. Regardless of the cause, emphysema has no cure and lasts a lifetime.
The majority of cases of COPD are related to smoking. You can drastically reduce your risk of COPD by avoiding cigarettes.
In addition, avoid outdoor activities when air pollution levels are high.
If you have chronic bronchitis, avoid contact with anyone with an upper respiratory tract infection. Even a mild cold can trigger a flare-up of bronchitis symptoms.
During cold and flu season:
Anyone with COPD should be vaccinated against influenza and pneumococcal pneumonia.
No treatment can fully reverse or stop COPD.
Treatment aims to:
Other COPD treatments may include:
People with COPD should avoid exposure to outdoor air pollution and secondhand smoke. Also avoid other airborne toxins, such as deodorants, hair sprays and insecticides.
Antibiotics may be necessary to treat acute respiratory infections.
Daily inhaled corticosteroids can reduce airway inflammation. For flare-ups, an oral corticosteroid called prednisone often is prescribed.
See your doctor annually to check for early signs of lung disease if you:
You should be tested for alpha-1-antitrypsin deficiency if you have fmaily members with the problem. If you already know that you have alpha-1-antitrypsin deficiency, have your breathing monitored regularly for early signs of emphysema.
Call your doctor whenever you have:
There is no cure for COPD. Do the following to improve your function and sense of well-being:
People with COPD who continue to smoke can expect progressive deterioration of lung function. Quitting completely is the best chance of stopping or slowing down the process.
It is never too late to quit. Even with severe chronic bronchitis, symptoms can improve.
The lung damage from emphysema cannot be reversed. However, quitting smoking can decrease the risk of additional harm to the lungs.
American Lung Association
61 Broadway, 6th Floor
New York, NY 10006
National Heart, Lung, and Blood Institute (NHLBI)
P.O. Box 30105
Bethesda, MD 20824-0105